Rosacea affects over 14 million Americans. That’s roughly four to five percent of people living in the United States. The skin condition can be identified by chronic reddened skin, typically appearing on the face, but can bring on additional symptoms such as small, pus-filled bumps, visible blood vessels, and more uncomfortable symptoms that may worsen over time.
Research shows that when a person suffers from rosacea, there’s a higher chance of the same person experiencing other disorders simultaneously — specifically autoimmune diseases. That leaves many people wondering whether rosacea itself falls under the classification of an autoimmune condition.
What Is an Autoimmune Disease?
To understand whether or not rosacea is an autoimmune condition, we first need to define what an autoimmune disease is… A disorder classified as autoimmune is any condition where your immune system mistakenly attacks your own body.
In the case of a healthy, normal-functioning immune system, your immune system works to protect your body against foreign invaders, such as bacteria and viruses. Your immune system knows the difference between an environmental threat and your own cells.
That’s not the case when you suffer from an autoimmune disease. For example, systemic lupus erythematosus (SLE) occurs when the immune system attacks and affects the whole body. In the case of type 1 diabetes, your immune system only mistakenly attacks your pancreas.
Possible Root Causes of Rosacea
For rosacea to be classified as an autoimmune condition, that means doctors and researchers would need proof that the flushed skin results from your immune system mistakenly attacking your body.
So, while there is no concrete cause of rosacea (yet!), let’s consider the possible causes of rosacea we’re aware of today:
Rosacea seems to run in the family, thanks to genetics. Researchers at Stanford have found two particular areas of the genome that are linked to rosacea. On top of a family history of rosacea, specific demographics are more susceptible to the disease, including females, those with fair skin, those between the ages of 30 and 50 years old, as well as blond-haired, blue-eyed people of Northern European descent.
Unbalanced Skin Microbiome & Skin Mites
Billions of microorganisms live on the surface of your skin and make up the skin microbiome. The microorganisms include everything from bacteria, viruses, and fungi to mites.
Demodex folliculorum is a type of mite typically found on your face around the eyelids and lashes. D. folliculorum normally live harmlessly on your skin, but if the number of Demodex folliculorum living on the skin increases and throws off the balance of your skin microbiome, research shows these skin mites may contribute to the development of rosacea.
Research found that rosacea patients had 15–18 times more Demodex mites than patients without facial redness. This increased number of mites seems to cause inflammation in the skin... However, researchers don’t believe it’s the mites themselves that trigger the inflammatory immune response — but the bacteria they carry. Demodex mites carry the bacteria Bacillus oleronius, which, in some individuals, has been linked to an inflammatory immune response.
Immune System Response
Your body’s innate immune system is its first line of defense against foreign threats. According to research, there is some evidence that this process is malfunctioning in the people suffering from rosacea. Studies show this may be a result of mast cells — or cathelicidins, a type of antimicrobial molecule that makes up part of the innate immune system and helps combat illness.
Cathelicidins, which are produced by your body in response to irritation or infection, can cause bumps, flushing, and visible blood vessels — all common symptoms of rosacea. In a study published in Nature Medicine, researchers found cathelicidins to be more abundant in those suffering from rosacea.
So, Is Rosacea an Autoimmune Disease?
To tell you the truth… The short answer is maybe. No one can say for certain whether or not rosacea is an autoimmune disease. In fact, there’s still a lot unknown about the skin condition. To this day, a cure and exact cause of rosacea continue to elude researchers and doctors alike.
Regardless of the gaps in our understanding of rosacea, there are some things we do know for certain — one of which being there is definitely some form of connection between rosacea and a faulty immune system.
The Correlation Between Rosacea and Autoimmune Diseases
While we can’t determine a clear cause-and-effect relationship between the two, research clearly shows a correlation between rosacea and autoimmune diseases.
In one 2015 genome-wide association study, researchers discovered that specific HLA alleles associated with rosacea have previously been found to be associated with type 1 diabetes and celiac disease, two common autoimmune diseases, which have been shown to share a similar genetic makeup as multiple sclerosis and rheumatoid arthritis.
A 2016 study published in the Journal of the American Academy of Dermatology gives more clear evidence to a connection between autoimmune conditions and rosacea. Those who suffer from rosacea are more likely to also have another autoimmune disease — especially women.
Investigators found that women with rosacea have higher rates of autoimmune diseases, including type 1 diabetes, celiac disease, multiple sclerosis, and rheumatoid arthritis. The research found that men, on the other hand, were only more likely to suffer from rheumatoid arthritis.
This research is just the beginning of better understanding the link between rosacea and autoimmune disorders.
Evidence does suggest rosacea’s association with the immune system and inflammatory processes. However, a lot remains unclear into how specifically these processes are triggered and then lead to flushed skin.
While you may not be able to completely uncover the root cause of your rosacea, the best thing you can do moving forward is work to find a treatment plan that manages your skin condition and helps to alleviate the pesky symptoms associated with it — whether the skin condition is classified as “autoimmune” or not.